Before you use MUSE for the first time, a doctor or nurse will have to give you a demonstration of how to do so, and may supervise your first application of it. You should not attempt to use it without having received these instructions first.

But for those who haven’t used MUSE before, we thought it might be helpful to put together a brief guide detailed what using it involves. You can also find more detailed instructions in the patient information leaflet, and diagrams of how to apply it. Before use, you should make sure you read these, to help ensure the medicine is effective, and minimise the risk of side effects.

How to use MUSE

MUSE is administered via an applicator which is used to insert the pellet of alprostadil into the urethra. It comes in a foil pouch which is individually packaged.

Here is a step by step guide to using it; but again, you should not use this as your sole guide. Make sure to see a doctor first, and follow the instructions in the leaflet.

  1. It is easier to administer MUSE if the urethral passage is moistened, so it helps to urinate before inserting the pellet.
  2. It is advisable to massage the penis, as this will help it to extend and enable easier access for the pellet.
  3. Wash and dry your hands.
  4. Open the pouch and allow the applicator to slide out onto your hand.
  5. The applicator tip is sterile, so once uncovered you should make sure you do not touch it and that it does not touch anything else once it is removed from the protective pouch.
  6. Take off the cover from the applicator tip.
  7. Very gently stretch the penis, and then hold it upright.
  8. Gently insert the applicator into the tip of the penis, as shown in the diagram provided in the leaflet. If you feel any pulling or discomfort, carefully remove the applicator and slowly try to re-insert it.
  9. Once inserted, push the button on the end of the applicator, and then hold it in place for at least five seconds.
  10. Very gently move the applicator from side to side in order to release the contents, being careful not to scratch the inside of the urethra.
  11. Next, still holding the penis upright, slowly and carefully remove the applicator from the urethra, ensuring that there is no remaining liquid left inside. (If there is, follow the above steps again, inserting the applicator into the penis and expelling the remaining medicine, before removing once more.)
  12. Keeping the penis upright, roll it between your hands so that the alprostadil can cover the inside of the urethra.
  13. It’s recommended to either sit or get up and walk for around 10 minutes following application. This will enable the medication to circulate. It will also make the blood flow to the penis and thus your erection will be improved.
  14. Safely dispose of the applicator in the foil wrapper.
  15. You should experience and erection which lasts for between half an hour to an hour.
  16. It is normal for the penis feel more sensitive than usual following administration.
  17. If you feel a burning sensation, it may help to continue rolling your penis between your hands as shown in the diagram provided in the instructions.

If your erection does not go away and lasts for four hours or more following use, seek urgent medical attention.

Make sure you do not use more MUSE than you have been prescribed, and also that you do not use it more than twice in any one 24 hour period, or more than seven times in a week.

As mentioned above, more detailed instructions can be found in the patient information leaflet, which you can download from the Electronic Medicines Compendium.

Other points to keep in mind when using MUSE

Before you take MUSE, your doctor may want to check how your body is able to deal with vigorous physical activity, because sexual intercourse can increase your heart rate. So your overall health and fitness should ideally be examined by a doctor before you use any treatment for erectile dysfunction for the first time.

Following application, some patients may feel a slight burning sensation that can last for an hour or two, but this should not interfere with intercourse.

If you are using MUSE and your partner is pregnant, it is strongly recommended that you use a condom when having sex, to prevent the medicine being transferred to them.

If you are unsure about any part of the procedure for taking MUSE, consult your doctor and ask to go through it again.

Page last reviewed:  24/08/2018